We’ve all been there: a slight pain starts in your forehead, won’t quite go away and suddenly develops into a pounding headache. Immediate relief is required, and you just remembered there’s a bottle of aspirin in the bathroom medicine cabinet.
Then, your headache quickly gets worse – the aspirin expired last year!
The pain is unbearable and now you’re faced with a dilemma: roll the dice and take the expired medicine, or go the conservative route and throw it away.
But are you really tempting fate by using medication past its expiration date? Are fears of taking expired medicine real or imagined?
Why Medicine Expiration Dates (Kind Of) Matter
The debate and controversy surrounding the safety and effectiveness of taking expired medication – both prescribed and over-the-counter pills – has advocates and opponents on both sides of the argument.
The “live and let live” crowd will tell you that an expiration date on a bottle of medication is simply a date that drug manufacturers have to include on bottles in order to avoid any legal ramifications from adverse side effects.
On the opposite side of the aisle, there are those who say you should immediately discard any expired medicine; if you take blood pressure medication the day after it expires, you’re placing your life in your own hands. To this group, expired aspirin is akin to a carton of eggs two weeks past its expiration date.
But are aspirin like eggs? They’re both white (usually), both round (sort of) and both have a clearly marked expiration date. The similarities end there, as published research shows.
A recent study of expired prescription drugs suggests the worry-warts might be wrong after all. Researchers at the University of California, San Francisco analyzed a handful of prescription medications and discovered that the majority retained all of their laboratory-backed claims for up to 40 years after the expiration date.
One caveat of the study: the research didn’t measure medicinal effectiveness. Only the active ingredient levels were analyzed, and over 80% of the tested drugs had the acceptable level of active ingredients (at least 90%) decades after their manufacture date.
Still, UCSF researchers found no reason to believe the drugs couldn’t treat patients effectively. Upon the study’s publication, one researcher suggested medicine expiration dates should be updated.
How Expiration Dates Started – and What Those Dates Actually Mean
Way back in 1979, the U.S. Food and Drug Administration required all drug makers to mark over-the-counter and prescription medication with expiration dates, but this new law only seemed to complicate the matter further. Nearly 40 years later, the average patient has only a vague idea of what that expiration date actually represents. Before the FDA’s expiration date mandate, there wasn’t a clear cut-off as to when drugs were no longer effective. After 1979, it seemed there were more questions than answers.
Let’s boil it down in the simplest terms possible. Sharon Bergquist, a medical professor at Emory University, told the Wall Street Journal that the expiration date is “the final date up to which the manufacturer will guarantee that medicine has full potency.”
In other words, the expiration date is designed to give the patient the best possible idea of when their medication reaches maximum effectiveness. Once that date is passed, the medication starts to decline with age. But that decline is gradual, particularly for pills and powder capsules. Liquid capsules and other fluid or water-based medications (gels, ointments, etc.) generally have accurate expiration dates.
However, Dr. Bergquist also said, “That doesn’t mean that [the exact expiration date] is the day that medication will become ineffective or unsafe.”
Safety Over Symptom Relief: The FDA’s Paramount Principle (with Help from Pharmacists)
Let’s revisit that 1979 FDA law for a minute. The official regulation behind medicine expiration dates is, “To assure that a drug product meets applicable standards of identity, strength, quality and purity at the time of use, it shall bear an expiration date determined by appropriate stability testing.”
That “identity, strength, quality and purity” can be achieved by a variety methods, as long as drug manufacturers meet the FDA mandate of 90 – 110% of the active medicine ingredient. A hypertension prescription can claim to do X, Y and Z, assuming that the medication’s active ingredient(s) are plus / minus 10% (90 – 110%) as to what is identified on the label.
As the UCSF study illustrates, most expired drugs maintain that 90 – 110% active ingredient range for up to 40 years beyond the expiration date – before the FDA law was on the books!
Most medications sold in the United States are automatically given an expiration date anywhere from one to five years after the date of manufacture. However, here’s where things get interesting: pharmacists and doctors can drastically alter the expiration date by further restricting the original information. Pharmacists typically add a “do not use beyond” or “discard after” date to common medications. This is usually due to storage temperature and conditions. Plus, pharmacists (much like drug manufacturers) also have a strong incentive to avoid legal prosecution, and they’re “playing it safe” by shortening the FDA-mandated expiration dates.
The Verdict: It’s Your Call
After reviewing multiple studies and researching the issue, what’s the final answer? Is it safe to take expired medicine?
For dry medication (tablets and powder capsules), the evidence clearly says yes. However, personal preference and ingrained habits are tough habits to break. If your parents threw expired medicine away, chances are you do, too. And that’s entirely OK.
We don’t recommend using expired medication years after the expiration date, and expired liquid medication should be discarded. If you’re going to take medication a few days or weeks after the expiration date, you probably won’t do any harm. But it’s always best to consult with your physician, just in case. To err on the side of caution is the best course of action.
So the next time you’re faced with that annoying headache, and you find out your aspirin expired last month, it’s your call: take the pills or find another bottle. If it’s been a decade beyond the expiration date, throw it away and replenish your medicine supply.
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For more information, please call our main office at (480) 988-9108. Thanks for visiting the UCE blog – check back for other useful medical info, health tips and more.